经皮椎体后凸成形术治疗脊柱转移瘤的临床观察

The clinical research of percutaneous kyphoplasty for treating vertebral metastases

目的观察应用椎体后凸成形术治疗脊柱转移瘤的疗效。方法共治疗29例患者76处脊柱转移瘤病灶,男11例,女18例,年龄30～82岁,平均63.7岁。影像学检查及术后病理证实有脊柱转移瘤。临床伴有明显持续性骨痛,症状持续时间为1～18个月,平均5.2个月。29例患者76处脊柱转移瘤病灶均给予椎体后凸成形术治疗。治疗前后观察疼痛强度的变化情况、患者的止痛药使用评分并行SF-12健康状况调查。结果29例患者76处病灶手术顺利完成。疼痛评分由治疗前的5.0～9.6,平均7.8±1.3减少为治疗后的2.8～5.5,平均3.9±0.9(P<0.01)。止痛药使用评分由治疗前的3～4,平均3.3±0.4,减少为治疗后的1～3,平均1.9±0.8(P<0.01)。SF-12健康调查评分治疗前为-17～-34,平均-29.1±4.3,治疗后为-15～-33,平均-22.6±3.8(P<0.05)。术后随访3～18个月,平均8.7个月,患者疼痛症状及生活质量较术前改善满意。结论应用椎体后凸成形术治疗脊柱转移瘤可有效的缓解疼痛,改善患者后期生活质量。

Objective To discuss the methodology and efficacy of percutaneous kyphoplasty for treatment vertebral metastases. Methods Twenty-nine cases（female 18, male 11; aged 30-82 years, mean age 63.7） with vertebral metastases were treated, 76 tumour focus were observed. All patients were received X-ray, CT scanning, MRI and pathological examination, and all diagnosis were bone metastases with severe and persistent pain. The symptom of pain were sustaining from 1 to 18 months, average 5.2 months in arerage. The visual analog scale（VAS）, pain killer and SF- 12 health survey were compared between pre- and post- treatment. Results The therapy was successful in all patients. The severe bone pain was significantly relieved without obvious complication. VAS decreased from 5.0-9.6（ average 7.8±1.3） to 2.8-5.5（average3.9±0.9） （P〈0.01）; Pain killer decreased from 3-4（ average 3.3±0.4） to 1-3（ average 1.9±0.8） （P〈0.01） but SF-12 increased from-17～-34 （average -29.1±4.3） to - 15～- 33（average-22.6±3.8） （P〈0.05）. During the following-up 3-18 months（average 8.7 months）, it could effectively relieve patients＇ pain and improve their life quality. Conclusions It is demonstrated that percutaneous kyphoplasty for vertebral metastases can effectively relieve bone pain and improve patients＇ life quality.